Sue-Ann Le Grange is the wife of the Reverend Roy Le Grange, who, in Dean's words, "heals people out of a tent" at their home in rural Nebraska. She has bound a reaper with black magic, originally to keep it from claiming her terminally ill husband, but later using it to trade lives for lives to create the "miracles" of the Church of Roy Le Grange, Faith Healer. Sue-Ann goes through the local newspaper and collects clippings about people she finds immoral, on whom she sets the reaper while Roy heals the sick twice every Sunday. The process of binding and controlling a reaper is a complex spell involving blood, photographs, Latin, Coptic crosses and a black altar; she tells Sam that she's been chosen by God to reward the just and punish the wicked.

When Dean prevents Roy from healing Layla Rourke, Sue-Ann marks him as her next victim. After arguing with Dean that they shouldn't kill human beings, period, Sam stops Sue-Ann by smashing the amulet by which she's controlling the reaper. The reaper, now free, claims her, with no reciprocal healing for Layla. The town is told that Sue-Ann dies of a stroke.